Legal scholars, health care advocates and public officials participating in the Freedom's Voice Conference in April depicted a health and prison crisis that is limiting opportunities for people of color and devastating our communities. The three-day conference, which was sponsored by the Morehouse School of Medicine's Community Voices program, offered recommendations on how to address many of the problems. But the esteemed panelists also sent a clear message that there must be decisive action to reverse public policies sending record numbers of people to prison, leaving those outside prison walls without access to health care and restricting people of color to segregated communities. Dr. David Satcher, former U.S. Surgeon General, set the tone for the conference by recalling that Dr. Martin Luther King Jr. once stated that "of all of the forms of inequalities known to man, injustice in health is the most shocking and inhumane injustice." What the conference reinforced is that as bad as the health inequalities were in Dr. King's time, people of color today often face worse circumstances. Dr. Satcher put today's realities in context. During our times, Dr. Satcher said, "We know that inequality in criminal justice, inequality in jobs, inequality in working conditions all lead to injustice in health. We know that." With public policy debates intensifying due to this year's presidential election, the conference cited policies that should be expanded because they are helping communities, while criticizing policies negatively impacting communities of color. For instance, Nkechi Taifa, a senior policy analyst at the Open Society Policy Center, praised enactment of the Second Chance Act, which authorizes that strategic plans be developed for assisting juvenile and adult inmates to successfully reenter their communities and help them find jobs. Data shows that 700,000 inmates are released from prison each year, but about two-thirds return to prison within three years. Taifa said the measure will provide former convicts with better access to family unification, job training, education, housing, substance abuse and mental health services. But she also warned that only authorizing legislation was signed into law, and that supporters must fight for full funding of the program. In addition, she sharply attacked the consequences of the Adoption and Safe Families Act. While encouraging adoptions, it requires the termination of parental rights when a child is in foster care 15 of the previous 22 months. The law is particularly hard on incarcerated parents seeking to connect with their children. "Social and criminal justice policies and laws generated by the war on drugs still negatively and punitively impact those returning to society," Taifa said, noting that more measures are needed to help the children of incarcerated parents. Throughout the three days of the conference, many other issues were discussed, such as the rising number of uninsured Americans, laws that incarcerate people for minor crimes or drug violations, and the high incidence of infant mortality among African American women. Another recurring theme was the challenges that men of color face in our society. Judge Greg Mathis of Michigan noted that African American men represent nearly 60 percent of the nation's prison population, but are only six percent of our society. "What is the effect of that?" Judge Mathis asked. "Well, the effect, as it relates to health is: One, we have poverty, disproportionate poverty, single-family homes. And then, of course, and this might be somewhat controversial, but it's true, we have a higher rate of HIV and AIDS because in the prisons men engage - many of them, very many of them, in homosexual activity." Judge Mathis also noted that because only two states dispense condoms in prisons — Vermont and Mississippi — inmates have a high rate of HIV and AIDS, and then are released into communities across the country where they spread the disease. Moreover, Dr. John A. Powell, who is with the Kirwan Institute for the Study of Race and Ethnicity at Ohio State University, lamented that over the last 20 years inequities affecting people of color have worsened significantly after a period of improvement. "The United States has greater inequality than it's had since the 1920s. Inequality is expanding at a rapid rate, and the inequality that we experience today actually started in the 1980s," said Dr. Powell, a nationally recognized authority in the area of civil rights, civil liberties and issues related to race, poverty and the law. But Dr. Powell noted that in 1980 inequality began expanding. "It's also racially coded," he said. "Now, if you look at our life expectancy compared to the rest of the world, in 1980 we were Number 14. In 2007 we're Number 29, so in the same period that we see rapid inequality growing in the United States, we see a rapid decline in terms of our health status as a country. In our infant mortality rate, we're down to Number 31, behind countries that have fewer resources than we do as a country." Meanwhile, Angela Glover Blackwell, CEO and Founder of PolicyLink, emphasized how much "place matters" in our society, and that many of the social problems for people of color are related to their unhealthy surroundings. "We have an epidemic of childhood obesity in this country, and we are blaming mothers and fathers and the children themselves," she said. "Behavioral choices are a huge part of what impacts health. But it's not as if people are just going out and choosing the wrong things. It's not that children are choosing not to be involved with Little League. It's not that they are choosing not to play on the streets, as many of you probably had the occasion to do when you were growing up. They're not choosing not to go to parks. They're not choosing to eat unhealthy diets in a vacuum." The problem, Ms. Blackwell said, is that we have a society that has not paid attention to making sure that the healthy choices are the easy choices.

Dr. Henrie M. Treadwell is director of Community Voices: Healthcare for the Underserved of Morehouse School of Medicine. She is also associate director of Development at the National Center for Primary Care of Morehouse School of Medicine.